Healthcare Provider Details

I. General information

NPI: 1053991604
Provider Name (Legal Business Name): DELIABELL ROMERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23450 VIA COCONUT PT
ESTERO FL
34135-1877
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-468-0150
  • Fax:
Mailing address:
  • Phone: 239-468-0150
  • Fax: 239-343-4056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME161293
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: